Organization Active NPI

Mario N Genovese DPM, PC

  • Foot & Ankle Surgery Podiatrist
  • Brooklyn, NY
National Provider Identifier
1992981955
Registry record updated May 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
N004091 Issued in NY
Legal business name
MARIO N GENOVESE DPM, PC
Practice address
9602 4TH Ave
Apt. L1
Brooklyn, NY 11209-3439
Phone
(718) 748-7474
Fax
(718) 748-7474
NPI assigned
Jan 21, 2008
Last updated
May 12, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mario N Genovese, DPMNPI 1447337738
Title
Owner
Phone
(718) 748-7474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X N004091 NY Primary

Addresses

Primary practice location

9602 4TH Ave
Apt. L1
Brooklyn, NY 11209-3439

Mailing address

7715 4TH Ave
Brooklyn, NY 11209-3439
Phone (718) 748-7474

Other identifiers 1

IdentifierTypeStateIssuer
01008846MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110516000593 NY Part B Supplier - Clinic/Group Practice 8729296801 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1992981955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7715 4TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093439",
            "telephone_number": "718-748-7474",
            "fax_number": "718-748-7474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9602 4TH AVE",
            "address_2": "APT. L1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093439",
            "telephone_number": "718-748-7474",
            "fax_number": "718-748-7474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO N GENOVESE DPM, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-21",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "GENOVESE",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-748-7474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N004091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01008846",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.